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Organization

CHESAPEAKE CONTEMPORARY DENTISTRY, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH EDWIN MOOMAW D.D.S. (DOCTOR)
(410) 679-2790
Entity
Organization

Contact information

Practice address
1308 BUSINESS CENTER WAY, SUITE 105, EDGEWOOD, MD 21040-1504
(410) 679-2790
(410) 679-4207
Mailing address
1308 BUSINESS CENTER WAY, SUITE 105, EDGEWOOD, MD 21040-1504
(410) 679-2790
(410) 679-4207

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6960
MD

Other

Enumeration date
04/27/2010
Last updated
04/27/2010
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